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After Antietam

Charles Lewis Brigham joined the Union army to fight, but he learned more about medicine during his first months in the Civil War.

Hospitalized for severe diarrhea before ever seeing battle, the New Hampshire infantryman worked as a nurse for weeks afterward, keeping files, dressing wounds and even assisting with an amputation.

His help was needed after the 1862 Battle of Antietam, the bloodiest day on U.S. soil, when thousands of wounded soldiers were treated at makeshift hospitals in Frederick, Md.

The federal government chose the city, about 20 miles east of the battlefield, for its railroad lines and its proximity to Baltimore and Washington, each less than 50 miles away. The story is told in a new book, "One Vast Hospital: The Civil War HospitalSites in Frederick, Maryland, after Antietam."

Published by the Frederick-based National Museum of Civil War Medicine and written by museum researcher Terry Reimer, the book lists nearly 10,000 patients who passed through the 27 buildings that were pressed into service as hospitals from September 1862 through January 1863.

"If he was wounded at Antietam, he's more than likely listed in these hospitals," Reimer said.

Brigham, of Nashua, N.H., wasn't at Antietam on Sept. 17, 1862. He fell ill days earlier as Union troops gathered for the Sept. 14 Battle of South Mountain, according to letters that Jerrilee Cain, a Williamsburg, Mass., writer, obtained from Brigham's relatives for a book project.

On Sept. 21, he was admitted to General Hospital No. 5, which consisted of two buildings owned by the Roman Catholic Church, according to Reimer's book.

The hospital had the lowest death rate - about three per 1,000 - of the seven that were established across the city in churches, schools, hotels, homes and businesses, including a butcher shop, Reimer found. About half of the buildings still stand, she said.

The worst death rate among government-funded hospitals was at General Hospital No. 1, centered at the Hessian Barracks, a pair of two-story stone buildings built in 1777 that had held Hessian prisoners during the Revolutionary War. Patients were not put in the dilapidated barracks, but in eight nearby frame structures that weren't much better.

"These buildings are poorly constructed, defective in ventilation and proper means of protecting from rain, etc., and are only suitable for convalescents," Robert Fulton Weir, the surgeon in charge of Hospital No. 1, wrote in a letter requesting new wards.

Yet some of the worst gunshot wound cases were sent to the hospital, which sustained occasional outbreaks of smallpox and hospital gangrene, a contagious deadly infection, Reimer found. Its death rate was 16 per 1,000.

Brigham was sent there reluctantly when Hospital No. 5, where he had been working, was closed, Cain said.

"He mentions it in his letters," she said. "He claimed he did not want to go there."

Even worse was the privately funded Confederate hospital, General Hspital No. 7, housed in a tannery and a bowling alley. Funded by donations from Southern sympathizers, it probably treated fewer than 75 patients during its two-month life span, but its death rate was 15.3 percent, Reimer found.

Most of the Confederate wounded were treated at other hospitals by the Union medical corps, Reimer said.

So many wounded soldiers poured into Frederick that at one point their number equaled the city's population of 7,000 to 8,000, Reimer wrote. Local resident Jacob Englebrecht wrote in his diary for Oct. 29, 1862, of meeting three patients on the street: one missing his right arm, one missing his left arm and the third on crutches.

"If you would take a walk through the town any handsome day, you might meet 80 or 100 wounded soldiers," Englebrecht wrote.

Reimer took the title of her book from a Sept. 25, 1862, Philadelphia Inquirer article describing the city: "Figuratively speaking, this city is one vast hospital, and yet hundreds of poor fellows continue to arrive, who have their wounds attended to, and away they go, uncomplaining."